Active NPI
Nina Jean Syverson, MA., MSE.,LP
- Clinical Psychologist
- Rogers, MN
National Provider Identifier
1912070731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP1892
- Practice address
- 14165 James Rd Ste 200
Rogers, MN 55374-9317 - Phone
- (763) 428-6330
- Fax
- (763) 428-6314
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP1892 | MN | Primary |
Addresses
Primary practice location
14165 James Rd Ste 200
Rogers, MN 55374-9317
Mailing address
1485 81St Ave NE
Spring Lake Park, MN 55432-2111
Phone (763) 780-3036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1892 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Becoming Together Therapy and Wellness LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Eden Prairie, MN
- NPI 1285740217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1912070731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 81ST AVE NE",
"city": "SPRING LAKE PARK",
"state": "MN",
"postal_code": "554322111",
"telephone_number": "763-780-3036",
"fax_number": "763-784-0784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14165 JAMES RD STE 200",
"city": "ROGERS",
"state": "MN",
"postal_code": "553749317",
"telephone_number": "763-428-6330",
"fax_number": "763-428-6314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYVERSON",
"first_name": "NINA",
"middle_name": "JEAN",
"credential": "MA., MSE.,LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.